Individual provider Active NPI

Michele Alice St. Marie, MSW

  • Clinical Social Worker
  • Ocean, NJ
National Provider Identifier
1063602381
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06237700 Issued in NJ
Practice address
2 Wickapecko Drive
Ocean, NJ 07712
Phone
(860) 345-8939
NPI assigned
Aug 1, 2007
Last updated
Nov 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 7479 CT
Clinical Social Worker 1041C0700X 44SC06237700 NJ Primary

Addresses

Primary practice location

2 Wickapecko Drive
Ocean, NJ 07712

Mailing address

2 Wickapecko Drive
Ocean, NJ 07712
Phone (860) 685-1148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160405001549 CT Practitioner - Clinical Social Worker 0345547428 Practice locations: Middletown, CT
I20240105000361 NJ Practitioner - Clinical Social Worker 0345547428 Practice locations: Ocean, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Ocean, NJ 07712
Phone (860) 685-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7479CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
College Street Counseling Center LLC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1063602381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WICKAPECKO DRIVE",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "860-685-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WICKAPECKO DRIVE",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "860-345-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. MARIE",
        "first_name": "MICHELE",
        "middle_name": "ALICE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "7479",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06237700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

Verify at the official NPI Registry.